The Effect Of Self-Concealment On Depression In Patients After Hysterectomy-the Mediating Role Of Stigma

OBJECTIVE1.To describe the status of self-concealment,stigma and depression in patients after hysterectomy;2.To analyze the influencing factors of self-concealment,stigma and depression in patients after hysterectomy;3.To test whether stigma plays a mediating role in self-concealment and depression.METHODSThrough convenience sampling,205 patients who underwent hysterectomy in a tertiary hospital in Guangdong Province from January 2021 to December 2021 were selected for a cross-sectional questionnaire survey.The research tools are general information questionnaire,Self-Concealment Scale(SCS)、Stigma Scale for Chronic Illness(SSCI)、9 Items Patient Health Questionnaire(PHQ-9).Data analysis was performed using SPSS 22.0 software.Statistical description and influencing factors analysis were performed on self-concealment,stigma and depression.The mediating effect of stigma on self-concealment and depression was tested using the Process macro V3.3 of SPSS 22.0 software.RESULTS1.After hysterectomy,the average score of SCS in patients was(2.51±0.94),which was in the middle level.The average score of SSCI was(1.81±0.62),the internal stigma score was(1.99±0.71),and the external stigma score was(1.60±0.58).114 patients(55.61%)had different degrees of depression,including 82(40.00%)mild depression,26 moderate depression(12.68%),and 6 moderate to severe depression(2.93%).2.Surgical style and family function were the influencing factors of self-concealment,which explained 13.09%of the variation of self-concealment.Diagnosis,removal of bilateral ovaries,self-confidence and family function were the influencing factors of stigma,which explained 38.24%of the variance of stigma.Self-concealment and stigma were the influencing factors of depression,which explained 36.77%of the variance in depression.3.Mediating effect analysis showed that Bootstrap95%CI of the mediating effect of stigma did not include 0,indicating that self-concealment could affect depression through stigma,and its indirect effect value was 0.137,accounting for 63.63%of the total effect.CONCLUSION1.After hysterectomy,patients have moderate self-confidence,high stigma,and high incidence of depression.The psychological problems of this group should be paid attention to.2.According to the influencing factors of self-concealment,stigma and depression in patients after hysterectomy,we should pay attention to key groups in clinical nursing work,identify and intervene in time,and promote their mental health.3.Self-concealment can not only directly affect depression,but also indirectly affect depression through stigma.Targeted interventions can be taken to reduce stigma to prevent or improve depression in patients after hysterectomy.